Table 2: Examples of clinical and surrogate outcomes used to approve drugs, by therapeutic indication
Therapeutic indicationClinical outcomeSurrogate outcome
AllergyBulbar conjunctival injection and ocular itching (seasonal allergic conjunctivitis)No drugs approved
CancerDuration of survival (metastatic colorectal cancer)Proportion of patients who achieved complete response or partial response (Hodgkin lymphoma)
CardiovascularTime to first event of cardiovascular death, myocardial infarction and stroke (acute coronary syndromes)Change from baseline in trough sitting diastolic blood pressure (hypertension)
DermatologyChange in total inflammatory lesions in adults (rosacea)No drugs approved
GenitourinaryNumber of incontinence episodes per week (overactive bladder)No drugs approved
GastrointestinalNo emetic episode and no rescue medication within 24 hours (emetogenic chemotherapy)No drugs approved
GynecologyPercentage of women with a reduction in uterine bleeding (uterine fibroids)At least one follicle ≥ 17 mm, pre-ovulatory estradiol serum level ≥ 109 pg/mL (400 pmol/L), and mid-luteal phase progesterone level ≥ 7.9 ng/mL (25 nmol/L) (follicular development)
HematologyAnnualized bleeding rate per patient (congenital factor IX deficiency)Proportion of patients who experienced a hemoglobin response (anemia associated with chronic kidney disease)
Inborn error of metabolismProportion of patients alive and free of invasive ventilator support (Pompe disease)Reduction in mean spleen volume (type 1 Gaucher disease)
Infectious disease, hepatitisNo drugs approvedCell histology (hepatitis B)
Infectious disease, HIVNo drugs approvedProportion of patients with a treatment response ≥ 1 log10 reduction in viral load (HIV)
Infectious disease, otherImprovement in respiratory symptoms (cystic fibrosis)No drugs approved
Infectious disease, vaccineProtecting against severe rotavirus gastroenteritis episodes (rotavirus gastroenteritis)Ability to induce antibodies against viral hemagglutinin (influenza)
Metabolic disease, diabetesNo drugs approvedChange in glycosylated hemoglobin (type 2 diabetes)
Metabolic disease, otherNo drugs approvedPercent change in serum low-density lipoprotein cholesterol concentration (Frederickson type IIa familial hyperlipidemia)
MiscellaneousTime to onset of relief of symptoms of abdominal or facial attack (hereditary angioedema)Complete or partial cytogenetic response (graft-versus-host disease)
MusculoskeletalPain intensity, patient’s global assessment of disease activity, and the total score of the Western Ontario and McMaster Universities questionnaire (osteoarthritis of knee)No drugs approved
NeurologyMedian percent reduction in seizure frequency (epilepsy)Biochemical marker 8OH2’dG (Friedreich ataxia)
OphthalmologyProportion of patients who maintained vision (macular degeneration)Change from baseline in anterior chamber cell grade (anterior uveitis)
PsychiatryPositive and Negative Syndrome Scale total score (schizophrenia)No drugs approved
Pulmonary hypertensionTime to first occurrence of morbidity or mortality event (pulmonary arterial hypertension)Distance covered in 6-minute walking test (pulmonary hypertension)
RespirologyAnnual rate of moderate and severe exacerbations (chronic obstructive lung disease)Forced expiratory volume in 1 second and peak expiratory flow (asthma)
RheumatologyProportion of patients with an ACR20 response (rheumatoid arthritis)No drugs approved

Note: 8OH2’dG = 8-hydroxy-2'-deoxyguanosine, ACR20 = American College of Rheumatology 20% improvement response.